# Sleep Disturbance as a Mediator Between Problematic Social Media Use and Depressive Symptoms Among Mexican Undergraduate Nursing Students: A Multicenter Study

## TL;DR

This study finds that sleep problems partly explain how heavy social media use leads to depression in Mexican nursing students.

## Contribution

It identifies sleep disturbance as a key mediator linking social media addiction and depression in a nursing student population.

## Key findings

- 51.7% of students experienced sleep disturbance, and 27.5% reported depressive symptoms.
- Problematic social media use showed a dose–response relationship with both sleep disturbance and depression.
- Sleep disturbance mediated 31.4% of the effect of social media use on depression.

## Abstract

Background: Social media addiction is a growing concern among undergraduates, with nursing students particularly vulnerable as their stressful academic and clinical context may promote excessive use, impaired sleep, and higher depression risk. Therefore, we aimed to evaluate whether sleep disturbance mediates the association between problematic social media use and symptoms of depression among nursing students in Mexico. Methods: We conducted a multicenter, cross-sectional, analytical study using a random sample of 638 nursing students from three Mexican public universities. Between August and December 2024, participants completed validated scales for social media addiction, sleep quality, and depression. Counterfactual causal mediation analysis was performed using logistic regression with robust errors. Results: Sleep disturbance affected 51.7% of students, and 27.5% reported depression. Social media addiction showed a dose–response association with both outcomes. Mediation analysis revealed a total effect on depression (OR = 2.19; 95% CI = 1.45–3.30) and an indirect effect via sleep disturbance (OR = 1.22; 95% CI = 1.01–1.38), explaining 31.4% of the effect. Conclusions: Sleep disturbance partially mediates this association. Interventions addressing digital behavior and sleep hygiene may improve mental health in nursing students.